Fetal magnetic resonance imaging and neurosonography in congenital neurological anomalies: supplementary diagnostic and postnatal prognostic value

Garcia-Flores, Jose; Recio, Manuel; Uriel, Montserrat; Cañamares, Marina; Cruceyra, Mireia; Tamarit, Ines; Carrascoso, Javier; Espada, Mercedes; Cuesta, Ricardo Sáinz de la

doi:10.3109/14767058.2013.791275

Cited by 21 publications

(19 citation statements)

References 11 publications

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“…Clear details regarding USS technique (transabdominal or transvaginal, views obtained) and equipment (manufacturer, transducer) were provided in 21 studies [18–20, 22, 24–26, 28, 32–37, 39, 40, 42, 43, 47, 48, 50]. The remaining 13 studies [3, 21, 23, 27, 29–31, 38, 41, 44–46, 49] provided minimal information or details were not given.…”

Section: Resultsmentioning

confidence: 99%

“…The risk of bias due to conduct and interpretation of the index tests was low risk in 15/34 (44 %) [3, 18, 20, 21, 25, 28, 30, 32, 35–37, 40, 42, 43, 47], high risk in 4/34 (12 %) [38, 44–46] and unclear in 15/34 (44 %) [19, 22–24, 26, 27, 29, 31, 33, 34, 39, 41, 48–50]. Assessment of potential bias introduced by the reference standard was considered low risk in 19/34 (56 %) studies [3, 18, 19, 21, 22, 24, 28–31, 35, 36, 38, 40, 44, 47–50], high risk in nine (26 %) [20, 27, 32–34, 41, 43, 45, 46] and unclear in 6/34 (18 %) [23, 25, 26, 37, 39, 42], as there were a proportion of cases within the study that did not have a confirmed outcome or it was determined by clinical examination. Bias in the flow and timing as judged by timing between USS and iuMR imaging or due to methods used for analysis of findings was deemed low in 15/34 (42 %) [3, 18, 19, 23–25, 30, 32, 33, 35, 39, 46, 47, 49], high in 11/34 (32 %) [21, 26, 31, 34, 36–42] and unclear in 9/34 (27 %) [20, 22, 27–2...…”

Section: Resultsmentioning

confidence: 99%

“…Equally the impact of a wrong diagnosis made by iuMR was not defined in any study despite it occurring in 14/34 studies [18, 19, 21, 23, 26, 29, 33, 35, 36, 39–42, 44, 47]. …”

Section: Discussionmentioning

confidence: 99%

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A systematic review and meta-analysis to determine the contribution of mr imaging to the diagnosis of foetal brain abnormalities In Utero

et al. 2016

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ObjectivesThis systematic review was undertaken to define the diagnostic performance of in utero MR (iuMR) imaging when attempting to confirm, exclude or provide additional information compared with the information provided by prenatal ultrasound scans (USS) when there is a suspicion of foetal brain abnormality.MethodsElectronic databases were searched as well as relevant journals and conference proceedings. Reference lists of applicable studies were also explored. Data extraction was conducted by two reviewers independently to identify relevant studies for inclusion in the review. Inclusion criteria were original research that reported the findings of prenatal USS and iuMR imaging and findings in terms of accuracy as judged by an outcome reference diagnosis for foetal brain abnormalities.Results34 studies met the inclusion criteria which allowed diagnostic accuracy to be calculated in 959 cases, all of which had an outcome reference diagnosis determined by postnatal imaging, surgery or autopsy. iuMR imaging gave the correct diagnosis in 91 % which was an increase of 16 % above that achieved by USS alone.ConclusioniuMR imaging makes a significant contribution to the diagnosis of foetal brain abnormalities, increasing the diagnostic accuracy achievable by USS alone.Key points • Ultrasound is the primary modality for monitoring foetal brain development during pregnancy • iuMRI used together with ultrasound is more accurate for detecting foetal brain abnormalities • iuMR imaging is most helpful for detecting midline brain abnormalities • The moderate heterogeneity of reviewed studies may compromise findings

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Section: Resultsmentioning

confidence: 99%

Section: Resultsmentioning

confidence: 99%

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A systematic review and meta-analysis to determine the contribution of mr imaging to the diagnosis of foetal brain abnormalities In Utero

et al. 2016

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“…Several studies have reported a higher accuracy of MRI compared with ultrasonography for diagnosing CNS anomalies. Others have shown that additional anomalies diagnosed by MRI may lead to a change in counseling and/or management.…”

Section: Discussionmentioning

confidence: 99%

Diagnostic accuracy of ultrasonography and magnetic resonance imaging for the detection of fetal anomalies: a blinded case-control study

Gonçalves

Lee

Mody

et al. 2016

Ultrasound Obstet Gynecol

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Objectives To compare the accuracy of two-dimensional ultrasound (2D-US), three-dimensional ultrasound (3D-US) and magnetic resonance imaging (MRI) for the diagnosis of congenital anomalies without prior knowledge of indications and previous imaging findings. Methods This was a prospective, blinded case–control study comprising women with a singleton pregnancy with fetal congenital abnormalities identified on clinical ultrasound and those with an uncomplicated pregnancy. All women volunteered to undergo 2D-US, 3D-US and MRI, which were performed at one institution. Different examiners at a collaborating institution performed image interpretation. Sensitivity and specificity of the three imaging methods were calculated for individual anomalies, based on postnatal imaging and/or autopsy as the definitive diagnosis. Diagnostic confidence was graded on a four-point Likert scale. Results A total of 157 singleton pregnancies were enrolled, however nine cases were excluded owing to incomplete outcome, resulting in 148 fetuses (58 cases and 90 controls) included in the final analysis. Among cases, 13 (22.4%) had central nervous system (CNS) anomalies, 40 (69.0%) had non-CNS anomalies and five (8.6%) had both CNS and non-CNS anomalies. The main findings were: (1) MRI was more sensitive than 3D-US for diagnosing CNS anomalies (MRI, 88.9% (16/18) vs 3D-US, 66.7% (12/18) vs 2D-US, 72.2% (13/18); McNemar’s test for MRI vs 3D-US: P=0.046); (2) MRI provided additional information affecting prognosis and/or counseling in 22.2% (4/18) of fetuses with CNS anomalies; (3) 2D-US, 3D-US and MRI had similar sensitivity for diagnosing non-CNS anomalies; (4) specificity for all anomalies was highest for 3D-US (MRI, 85.6% (77/90) vs 3D-US, 94.4% (85/90) vs 2D-US, 92.2% (83/90); McNemar’s test for MRI vs 3D-US: P=0.03); and (5) the confidence of MRI for ruling out certain CNS abnormalities (usually questionable for cortical dysplasias or hemorrhage) that were not confirmed after delivery was lower than it was for 2D-US and 3D-US. Conclusions MRI was more sensitive than ultrasonography and provided additional information that changed prognosis, counseling or management in 22.2% of fetuses with CNS anomalies. False-positive diagnoses for subtle CNS findings were higher with MRI than with ultrasonography.

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“…In fact, the most reliable predictor for the development of neurological damage in CMV‐infected fetuses is viral load. It is now accepted that ultrasound and fhMRI are complementary methods. The most common fh‐detected pathologies in CMV‐infected fetuses are T2‐weighted hyperintense signals in subcortical white matter and anatomical changes.…”

Section: Discussionmentioning

confidence: 99%

Region-specific reductions in brain apparent diffusion coefficient in cytomegalovirus-infected fetuses

Gal

Hoffmann

Weisz

et al. 2016

Ultrasound Obstet Gynecol

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Fetal magnetic resonance imaging and neurosonography in congenital neurological anomalies: supplementary diagnostic and postnatal prognostic value

Cited by 21 publications

References 11 publications

A systematic review and meta-analysis to determine the contribution of mr imaging to the diagnosis of foetal brain abnormalities In Utero

A systematic review and meta-analysis to determine the contribution of mr imaging to the diagnosis of foetal brain abnormalities In Utero

Diagnostic accuracy of ultrasonography and magnetic resonance imaging for the detection of fetal anomalies: a blinded case-control study

Region-specific reductions in brain apparent diffusion coefficient in cytomegalovirus-infected fetuses

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